Healthcare Provider Details

I. General information

NPI: 1457078412
Provider Name (Legal Business Name): ACCESS IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 MCGILLIC RD
MALONE NY
12953-5007
US

IV. Provider business mailing address

157 MCGILLIC RD
MALONE NY
12953-5007
US

V. Phone/Fax

Practice location:
  • Phone: 518-481-3309
  • Fax:
Mailing address:
  • Phone: 518-481-3309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY PAYNE
Title or Position: OWNER
Credential:
Phone: 518-521-4870